Cronin Thomas, Arshad Qadeer, Seemungal Barry M
Division of Brain Sciences, Department of Medicine, Charing Cross Hospital, London, United Kingdom.
Front Neurol. 2017 Oct 26;8:538. doi: 10.3389/fneur.2017.00538. eCollection 2017.
The vestibular system consists of the peripheral vestibular organs in the inner ear and the associated extensive central nervous system projections-from the cerebellum and brainstem to the thalamic relays to cortical projections. This system is important for spatial orientation and balance, both of critical ecological importance, particularly for successful navigation in our environment. Balance disorders and spatial disorientation are common presenting features of neurodegenerative diseases; however, little is known regarding central vestibular processing in these diseases. A ubiquitous aspect of central vestibular processing is its promiscuity given that vestibular signals are commonly found in combination with other sensory signals. This review discusses how impaired central processing of vestibular signals-typically in combination with other sensory and motor systems-may account for the impaired balance and spatial disorientation in common neurodegenerative conditions. Such an understanding may provide for new diagnostic tests, potentially useful in detecting early disease while a mechanistic understanding of imbalance and spatial disorientation in these patients may enable a vestibular-targeted therapy for such problems in neurodegenerative diseases. Studies with state of the art central vestibular testing are now much needed to tackle this important topic.
前庭系统由内耳中的外周前庭器官以及相关的广泛中枢神经系统投射组成，这些投射从小脑和脑干到丘脑中继再到皮质投射。该系统对空间定向和平衡很重要，这两者都具有至关重要的生态学意义，特别是对于在我们的环境中成功导航而言。平衡障碍和空间定向障碍是神经退行性疾病常见的表现特征；然而，对于这些疾病中的中枢前庭处理知之甚少。中枢前庭处理的一个普遍特征是其混杂性，因为前庭信号通常与其他感觉信号结合出现。本综述讨论了前庭信号的中枢处理受损（通常与其他感觉和运动系统结合）如何可能导致常见神经退行性疾病中平衡和空间定向障碍。这样的理解可能会提供新的诊断测试，可能有助于在早期疾病检测中发挥作用，而对这些患者平衡和空间定向障碍的机制性理解可能会促成针对神经退行性疾病中此类问题的前庭靶向治疗。现在迫切需要进行最先进的中枢前庭测试研究来解决这个重要课题。
